Fertility & Pregnancy

Fertility and Pregnancy Planning: Preparing for the big project

From desire to planning

The journey to starting a family is an exciting step, but it can also come with its share of questions and uncertainties. Whether you are just beginning to think about it or are already in the process, preparing your body and mind is a key action.

This guide aims to give you accurate information and reliable tools to optimize your health in the pre-conception phase and to navigate this journey with confidence.

Pre-conception: the key steps to prepare

The period before conception is a window of opportunity to optimize your health.

• Folic acid and prenatal vitamins: This is the most important advice. Starting to take folic acid and prenatal vitamin supplements at least 3 months before trying to conceive is crucial to prevent serious neural tube defects in the fetus.
• Medication review: This is the time to speak with your pharmacist. We can review all your medications with you (prescription, over-the-counter, natural products) to ensure they are safe for conception and a potential pregnancy.
• Lifestyle: Quitting smoking and alcohol, as well as maintaining a healthy diet, are factors that can improve fertility and contribute to a healthy pregnancy.

Understanding your cycle to optimize your chances

Knowing your menstrual cycle allows you to better identify the "fertility window," which is the few days when the chances of conception are highest. This window generally occurs in the days leading up to ovulation and on the day of ovulation itself.

To better target this period, several tools are at your disposal:

• Cycle tracking apps: Many mobile applications are very useful for tracking the length of your cycles and predicting your ovulation period.
• Ovulation tests: Available at the pharmacy, these easy-to-use tests detect the hormonal surge that signals imminent ovulation.

Special considerations: HIV, PrEP, and Sexual Health

Planning a pregnancy while living with HIV

Thanks to modern treatments, it is entirely possible to conceive a child without transmitting HIV. The U=U (Undetectable = Untransmittable) principle applies: a person whose viral load is undetectable thanks to their treatment cannot transmit the virus to their partner.

PrEP, pregnancy, and breastfeeding

• Oral PrEP (TDF/FTC - Truvada® and generics) is the most studied option and is considered safe for people at risk who are trying to conceive, during pregnancy, and while breastfeeding.
• Injectable PrEP (Apretude®), although effective in cisgender women, does not yet have sufficient data to be recommended during pregnancy at this time. A discussion with your healthcare team is essential to choose the right option.

When to consult for fertility issues

It is completely normal for a pregnancy not to occur in the first few tries. It is generally recommended to consult a doctor if a pregnancy has not been achieved after 12 months of trying (or 6 months if the woman is over 35).

Many options and pathways exist to help you. The most important thing is not to remain alone with your concerns.

Trusted resources to support you

• Pregnancy Planning:

  • Naître et grandir (FR): The Quebec reference for all stages of parenthood.
  • Sex & U by the SOGC : Leading medical information on pre-conception from the Society of Obstetricians and Gynaecologists of Canada.

• Finding a professional for pregnancy follow-up in Quebec:

  • Ma Grossesse Service (EN/FR): The Government of Quebec's tool to find a professional (doctor, midwife).

• Fertility and Infertility Support:

  • Fertility Matters Canada (EN/FR): The leading support and information organization on infertility in Canada.
  • IAAC (Infertility Awareness Association of Canada) (EN/FR): Another major Canadian network offering patient support.